Assessment & Research

Communication difficulties in adults with Intellectual Disability: Results from a national cross-sectional study.

Smith et al. (2020) · Research in developmental disabilities 2020
★ The Verdict

Over half of adults with ID struggle to communicate—screen early using four clear red flags.

✓ Read this if BCBAs doing adult intake assessments in residential or day-program settings.
✗ Skip if Clinicians who only serve verbal clients with mild ID.

01Research in Context

01

What this study did

Martine and team asked 601 adults with intellectual disability across Ireland about their communication skills.

They used a big national survey to see who had trouble talking, listening, or being understood.

The team also checked if Down syndrome, behavior issues, or low social activity made problems worse.

02

What they found

Six out of ten adults had some communication difficulty.

People with more severe ID, Down syndrome, little social contact, or challenging behavior were at highest risk.

These four red flags can help you spot clients who need extra support.

03

How this fits with other research

Fellinger et al. (2022) found the same link in deaf adults with ID. Poor language skills predicted more behavior problems, not IQ scores.

Matson et al. (2009) showed adults with ID already have tiny social networks. Martine adds that low social contact also predicts worse communication.

Beadle-Brown et al. (2002) tracked the same people over time and found social problems stay stable. This means early communication help is critical because social gaps rarely close on their own.

04

Why it matters

Use these four red flags during intake: severe ID label, Down syndrome, reports of challenging behavior, and low social activity. When any two show up, run a full communication assessment right away. Early work on language and social skills can prevent bigger behavior issues later.

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Add a quick four-item checklist to your intake form: severe ID, Down syndrome, challenging behavior, low social contact—flag any two for immediate speech-language referral.

02At a glance

Intervention
not applicable
Design
other
Sample size
601
Population
intellectual disability, down syndrome
Finding
not reported

03Original abstract

BACKGROUND: People with an intellectual disability (ID) are vulnerable to communication impairments, with consequences for employment, education, and social participation. AIMS: To identify the communication skills of a population of adults (40+ years) with ID and explore relationships between individual and environmental factors and communication skills. METHODS AND PROCEDURES: Data from a sample of 601 adults with ID was selected from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) addressing communication characteristics, demographics, co-morbidities, challenging behaviours, and social participation. A multiple regression model and a decision-making tree were built to identify factors related to communication abilities. OUTCOMES AND RESULTS: Overall, 57.9 % of participants experienced communication difficulties, with 23.5 % reporting severe difficulties. Only 75.1 % of participants communicated verbally; more than half found communicating with professionals and non-familiar partners difficult. Level of ID, low social participation, challenging behaviours, and diagnosis of Down syndrome were significantly associated with communication difficulties. CONCLUSIONS AND IMPLICATIONS: Communication difficulties are prevalent in adults with ID and are influenced by complex factors. Interventions to enhance interaction and quality of life of individuals with ID should consider communication opportunities, needs, and barriers.

Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2019.103557